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Glossary

Forms

NII forms for submitting a claim for benefit and for matters of insurance and collection of insurance contributions.

The forms are in PDF format. For viewing or printing them you need Acrobat Reader, available for free on the internet. To download  Acrobat Reader and for guidelines, click here.

Please note:
to every claim submitted to the NII you should attach a cancelled check or a bank statement confirming that the claimant is the holder of the bank account indicated on the claims form. This does not apply to claims for unemployment benefit, maternity allowance, injury allowance or reserve service benefit.


 
  General
  Accident Contributions
  Alimony
  Bankruptcy
  Children
  Domestic Violence
  Employers
  General Disability
  Income Support
  Injury Allowance
  Insurance and Collection
  Long-Term Care
  Maternity
  Mobility
  Old Age and Survivors
  Prisoners of Zion and Families of Martyrs
  Rehabilitation
  Required Work Grant
  Reserve Service
  Unemployment
  Victims of Hostilities
  Work Disability and Dependants

FormOrderDownloadFill in
16 - Request of a Public Entity for InformationClick for details
הזמנהDownload
17 - Waiver for Insurance CompaniesClick for details
הזמנהDownload
18 - Waiver of Medical Confidentiality and Authorization to Provide InformationClick for details
הזמנהDownload
20 - Request for Grant for Justice ReasonsClick for details
 Download
8015 - Request for an Available Position as a Civil ServantClick for details
 Download
8129 - Addendum to Available Position Application FormClick for details
 Download
851 - Request for InformationClick for details
 Download
900 - Notification of Personal Detail UpdateClick for details
הזמנהDownload

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FormOrderDownloadFill in
Claim for Accident Injury Allowance - 2201Click for details
הזמנהDownload

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FormOrderDownloadFill in
Payment Request Under the Alimony Law - 5400Click for details
הזמנהDownload

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FormOrderDownloadFill in
5305 - Payment Claim for Salary Debt and Termination CompensationClick for details
הזמנהDownload
Payment Claim for Debt to Provident Fund - 5310Click for details
הזמנהDownload

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FormOrderDownloadFill in
5015 - Study GrantClick for details
 Download
5020 - File Split RequestClick for details
 Download
5025 - Personal Claim Form for Child AllowanceClick for details
 Download
5026 - Request to Change Payment Location, Address, Allowance RecipientClick for details
 Download

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FormOrderDownloadFill in
Compensation Claim Under the Compensation Law - 235Click for details
הזמנהDownload

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FormOrderDownloadFill in
103 - Employee CardClick for details
 Download
Subcontractor Notification - 648Click for details
 Download
659 - Refund Application for Insurance Contribution and/or Health Insurance ContributionClick for details
 Download
614 - Housekeeper Employment NotificationClick for details
 Download
752 - Application for Insurance Contribution RefundClick for details
הזמנהDownload
753 - Application for Insurance Contribution CoordinationClick for details
הזמנהDownload

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FormOrderDownloadFill in
3209 - Statement of Employment and Income of Disabled Person and SpouseClick for details
 Download
7801 - Claim for Disability Pension and Statement for Insurance and Collections DepartmentClick for details
 Download
Claim for Benefit for Disabled Child - 7821Click for details
 Download
Attendance Allowance for Those Not Receiving Disability Pension - 7849Click for details
 Download
Attendance Allowance Claim for Those Receiving Disability Pension/Claim for Attendance Allowance for Immigrants - 7850Click for details
 Download
claim for compensation under Polio Victims Compensation Law-2007Click for details
 Download
7870Click for details
 Download

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FormOrderDownloadFill in
Self-Filling Form - Claim for Income Support Benefit - 5619Click for details
הזמנהDownload

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FormOrderDownloadFill in
Claim for Injury Allowance and Notification of Work Injury - 211Click for details
הזמנהDownload
250 - Form for Providing Medical Treatment for a Work InjuryClick for details
 Download
Authorization to Provide Medical Care to a Self-employed Person Injured at Work - 283Click for details
 Download

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FormOrderDownloadFill in
6101 - Multi-Annual ReportClick for details
הזמנהDownloadמילוי
6127 - Direct Debit Order Authorization FormClick for details
הזמנהDownload
6130 - Request for Credit RefundClick for details
 Download
6134 - Request for Cancellation/Reduction of Fines and LinkageClick for details
 Download
627 - Questionnaire for Determination of Citizenship for People AbroadClick for details
 Download
628 - Questionnaire for Determining Residency of Persons Returning From AbroadClick for details
 Download
630 - Request to Join the Client Representation SystemClick for details
 Download
631 - Request for deposition of Joint PropertyClick for details
 Download
672 - Request to Correct Tax AdvancesClick for details
 Download
68 - Adding/Deleting UsersClick for details
 Download
69 - Canceling RepresentationClick for details
 Download
6978 - Direct Debit Order and Standing Order AgreementClick for details
 Download
70 - Power of Attorney for RepresentativeClick for details
 Download

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FormOrderDownloadFill in
Claim for Long-term Care Benefit - 2600Click for details
הזמנהDownload
Request to Re-Examine an Eligible Person Due to the Claim of Deterioration - 2620Click for details